To the Editor Some points in the review by Drs Lip and Lane1 about stroke prevention in atrial fibrillation deserve further discussion.
We disagree with the suggestion of using the score for sex, age, medical history, treatment, tobacco, and race (SAMe-TT2R2) as a tool for assessing patients’ eligibility for treatment with a non–vitamin K antagonist oral anticoagulant (NOAC). Use of the SAMe-TT2R2 score in everyday clinical practice would require great caution and further evaluation, especially considering that it has been validated as a tool for predicting poor international normalized ratio (INR) control rather than the effect of anticoagulation strategies on clinical outcomes in real-world practice.2
Marietta M, Formoso G, Marata AM. Assessing Eligibility for Anticoagulation After Diagnosis of Atrial Fibrillation. JAMA. 2015;314(9):949. doi:10.1001/jama.2015.8992